This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The specific aim of this proposal is to develop an integrative, multidisciplinary craniofacial clinic at Kapi'olani Medical Center for Women and Children. The overarching goal of this clinic is two-fold. First is to develop a multidisciplinary cleft and craniofacial disorders program where children in the state of Hawaii can be followed from birth to adolescence. Second is to provide an infrastructure to study this unique pediatric population. This is a formal request of the Clinical Research Center to help coordinate our concerted efforts towards the development of a comprehensive, multidisciplinary clinic for the support of children with cleft lip and/or palate. This clinic is in response to an identified need for multidisciplinary long term management for these patients from birth to 21 years of age. The goal of the Craniofacial Clinic is to assist families of these unique children with the daily challenges they face, such as feeding, somatic growth, neurodevelopment and speech/language development. In addition, we plan to coordinate the appropriate scheduling of surgical (reconstructive and otolaryngology) and dental interventions. The clinic will be headed by Charles Neal, MD, PhD, Medical Director of the Newborn Special Care Unit at Kapi'olani Medical Center for Women and Children, and Lynn Iwamoto, MD, a neonatologist at Kapi'olani Medical Center for Women and Children with specialized interest in newborn hearing. The craniofacial reconstruction team will be headed by Dr. M. Barbera Honnebier, MD, PhD, a Pediatric Reconstructive Surgeon out of Queens Medical Center. The clinic team will consist of a neonatologist, pediatrician, behavioral pediatrician, plastic surgeon, geneticist, otolaryngologist, dentist, nurse, speech therapist and audiologist. We will be joined by a nurse case manager and social worker from the Department of Health (DOH) Special Health Needs Division, who will assist families with obtaining and coordinating services outside of the clinic in the community. The format will follow the American Cleft Palate-Craniofacial Association recommended standard of care, which is a minimum of six half day clinics per year.